Individual
THERESA BENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1910 MCDONALD DR, CHAMPAIGN, IL 61821-6055
(330) 432-3479
Mailing address
1910 MCDONALD DR, CHAMPAIGN, IL 61821-6055
(330) 432-3479
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071008398
IL
103TC1900X
Counseling Psychologist
071008398
IL
Other
Enumeration date
07/25/2014
Last updated
06/03/2020
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